咽喉反流性疾病患者食管上括约肌压力高分辨测量的诊断价值  

Diagnostic value of high-resolution manometry of upper esophageal sphincter pressure in patients with laryngopharyngeal reflux disease

作　　者：刘俊伟[1] 郑城婷 郑仕诚[2] 张恒 LIU Junwei;ZHENG Chengting;ZHENG Shicheng;ZHANG Heng(Department of Otolaryngology,the First People’s Hospital of Longquanyi District,Chengdu 610100,China;Department of Gastroenterology,The First People’s Hospital of Longquanyi District,Chengdu 610100,China)

机构地区：[1]成都市龙泉驿区第一人民医院耳鼻咽喉科,四川成都610100 [2]成都市龙泉驿区第一人民医院消化内科,四川成都610100

出　　处：《中国耳鼻咽喉颅底外科杂志》2020年第4期443-447,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：2019年四川省卫生健康委员会科研课题(19PJ027)。

摘　　要：目的分析咽喉反流性疾病(LPRD)患者食管上括约肌(UES)压力高分辨测量(HRM)的应用价值。方法对71例咽部异感患者及28例健康志愿者进行UES压力HRM,根据反流症状指数(RSI)量表评分将71例患者分为咽喉反流组(A组,31例,RSI>13分)及非咽喉反流组(B组,40例,RSI≤13分),健康志愿者为C组(28例)。A、B、C组性别构成、平均年龄及平均体质指数(BMI)经比较差异无统计学意义(P均>0.05),具有可比性。结果3组生活质量评价量表(SF-36)评分A组患者(91.44±4.17)分显著低于B组的(99.51±5.86)分及C组的(114.03±5.29)分(P均<0.05);平均UES静息压A组为(104.50±33.84)mmHg,B组为(76.34±20.08)mmHg,C组为(46.92±11.56)mmHg,A组与B、C组比较差异均具有统计学意义(P均<0.05);残余压A组为(26.31±8.27)mmHg,B组为(15.40±7.19)mmHg,C组为(10.25±4.74)mmHg,A组与B、C组比较差异均具有统计学意义(P均<0.05)。A、B、C组平均远端收缩积分(DCI)及平均远端潜伏期(DL),经比较差异无统计学意义(P均>0.05)。结论LPRD患者生活质量评分较低,其症状的出现可能与UES静息压及残余压增高有关,UES静息压及残余压测量可为LPRD的诊断及其预后判断提供一定的参考价值。Objective To analyze the clinical value of high-resolution manometry(HRM)of the pressure of the upper esophageal sphincter(UES)in patients with laryngopharyngeal reflux disease(LPRD).Methods 71 patients with pharyngeal paraesthesia symptoms and 28 normal subjects underwent HRM of UES pressure.On the basis of RSI score,71 patients were divided into pharyngeal reflux group(group A,31 cases,RSI>13 points)and without pharyngeal reflux group(group B,40 cases,RSI≤13 points),normal subjects group(group C,28 cases).There was no statistical difference in sex ratio,mean age and BMI among the three groups(all P>0.05).Results The SF-36 score in group A(91.44±4.17)was obviously lower than that in group B(99.51±5.86)and in group C(114.03±5.29)(all P<0.05).The mean USE resting pressure of three groups were(104.50±33.84)mmHg(group A),(76.34±20.08)mmHg(group B)and(46.92±11.56)mmHg(group C)respectively,and which was significantly higher in group A than in group B and C(P<0.05).The mean residual pressure of three groups were(26.31±8.27)mmHg(group A),(15.40±7.19)mmHg(group B)and(10.25±4.74)mmHg(group C)respectively,and which was significantly higher in group A than in group B and C(all P<0.05).The average distal contraction integral(DCI)and distal latency(DL)in three groups were no statistically significant.Conclusion The life quality score of patients with LPRD was lower,and the onset of the symptoms might be correlated with the increasing resting pressure and residual pressure of UES.The measurement of UES resting pressure and residual pressure could be valuable for the diagnosis and prognosis of LPRD.

关 键 词：咽喉反流性疾病 食管上括约肌 高分辨率食管测压 

分 类 号：R766.5[医药卫生—耳鼻咽喉科]